The Market for Chronic Care
I have argued before that, but for third-party payers, a market for chronic care would have developed long ago. What do entrepreneurs do in every other market? They find people with unmet needs and figure out low-cost ways of solving their problems. Yet with a large and growing number of uninsured and a growing number of people with high-deductible insurance, markets for chronic care may develop anyway.
In several cities, Walgreens is offering pharmacist consultation to diabetics. (The service is free now, but there may be charges later; and, in any event, Walgreens is selling them drugs.) If it works, the program may expand to asthma, high cholesterol and obesity.
Very interesting post. You’ve predicted this before.
Apparently, this is developing outside the third party payer system, as is the case with most patient-friendly innovations in health care.
Given the importance of continuity of care, how does Walgreens coordinate with your primary care physician?
There was an experiment in Ashville, North Carolina, where pharmicists advised diabetics on the drugs they were taking. I don’t know if there was much coordination with primary care physicians. However, there was a significant drop off in emergency room visits and I believe also in physician office visits.
This is a great idea.
There is little mystery why third-parties are not particularly good at treating chronic conditions like diabetes – and why patients are often non-compliant. Diabetes complications occur years after onset. And patients bear few of the financial consequences for non-compliance (or it occurs years later). The high costs that result from an insurer (and patient) failing to control diabetes usually falls on Medicare (and often, Medicaid) years down the road.
If diabetic patients had to bear more of the cost directly (and captured more of the benefits), not only would markets develop to treat them; but they would have the added incentive to avoid the huge costs that would accumulate later as a result of non-compliance.